IVF/ICSI June/July

[CakePigeon30]

Hi, couldn't see a thread for June yet so thought I would start one.

I'm on long protocol so actually starting down regulation on 28th May, egg collection not scheduled in until 8th July.

I am on NHS and this will be my first round. Was referred less than a year ago now and have managed to loose 2 and a half stone to get my BMI down.

Anyone else due to start around June?

Thank you! Yeah definitely going to be keeping an eye out for OHSS and change to a FET if needed. I'm resting up lots over the next few days (and next week too as I've booked it off work). Yes keeping my fluid intake and salt intake up, although interestingly the nurse said the salt thing is a myth?? But I've had some salty crisps and things anyway as I just fancy having them. Yes I did the ovitrelle trigger. Does a different trigger indicate a different process then?

The embryologist phoned this afternoon and said they don't know how many of the eggs are mature yet until they look to fertilise them later today. But said that once the the donor sperm sample was thawed (we're a same sex couple) it was actually a bit lower in terms of count than expected so they're going to do ICSI just to try and ensure as good fertilisation. Which is a bit annoying as we had to pay for the sperm and it's a lower count than they'd like for IVF, but fingers crossed it's still okay quality and we get some embryos. I'll hear tomorrow about hopefully how many eggs are mature and how many fertilised 🤞

Edit: sorry I meant to ask, how are you doing now with the OHSS? What were your symptoms from it?

@strawberrylaces12 Yeah absolutely - I did that and I'm now on a FET as I was diagnosed with moderate the day after I was meant to transfer. I felt so horrendous so honestly I really hope you manage to avoid it -- I wouldn't wish it on anyone! If you have the other trigger - Buserelin (or a version of that) - it reduces your risk of OHSS hugely as it doesn't have the HcG hormone in it that exacerbates OHSS (which is in Ovitrelle). But if you have Buserelin (the other trigger) you generally can't have a fresh as it breaks down your lining. I only know this as I asked (and listen to a million podcasts!) so if you have fresh you mostly have ovitrelle. That's what caused me the issues!

That's good that they are doing ICSI instead to ensure they get a better fertilisation - least there is that option. Is there anything you can get funded / compensated for that as you say, you pay for sperm at a certain quality, and it's really not your fault. Everything costs doesn't it. So frustrating!

I am doing okay babes - I am fully recovered and was signed off yesterday and officially OHSS free. Started my FET meds yesterday after I had the scan to give me the all clear on OHSS so building up to transfer - woohoo!! 💃

Symptoms honestly were agony. I was so bloated that all my skin broke and cracked etc as it was that pressured and distended. I had severe pain in my liver and kidney, and couldn't really move or lay, as it hurt too much. Every time I rolled over I could feel my liver move which was WEIRD! I couldn't really eat or drink as everything was squashed by the swelling and all the fluid, I was really breathless (I am very fit and slim but walking up the stairs killed me), I couldn't sleep as I was in agony, and the fluid that was on my kidney and liver was causing pain when I moved, so I basically stayed awake for 3 days haha! And I was sick quite a bit. Was delightful - really selling it aren't I? 😂

That sounds awful!! So sorry that you had to go through that and really glad you're recovered now. Did you have to go to hospital or did you go to the clinic for help? Was there anything they could do?

Ahh that makes sense re the trigger. I've had this trigger before with IUI but of course I didn't have anywhere near as many follicles then. I did have one cycle of IUI where I had like 8 follicles (thankfully not all at optimum size) and had the trigger injection but obviously no where near the same as 24!

In terms of the sperm, thankfully we are funded for ICSI so that was fine. Also we did sign to agree to T&Cs that covered them if the sperm didn't thaw as well as expected. One of those things I guess. If we end up with low fertilisation etc. then I may raise it but will see what the outcome is first 😊

Exciting about the upcoming FET, how are you feeling about it?

@strawberrylaces12 I probably have terrified you now - I really honest think I just got it bad. Most people if they get it get mild, I was just unlucky I guess! I was treated in the clinic thankfully, and had scans and bloods taken 3 times in the week I was ill, and was put on Clexane blood thinner injections (which I have the last one tonight - woohoo!) to stop me getting a blood clot from it, and was put on a minimal fluid intake, so opposite to what they say for mild. But it just got a lot better almost suddenly last Monday, and then when I had my withdrawal bleed that started Wednesday last week, I was so much better. And gradually got more and more well since, and now feel great!

Ah yes I remember you saying - do you have PCOS or just good egg numbers? I had the same thing with IUI for us, and got 12 one month and had to abandon. Annoying as like you, we were self funding at the time and it's frustrating it's £1,500 down the drain! How are you feeling this afternoon beside the discomfort in your ovaries? Did you enjoy the nice sleep too!!??

I'm looking forward to getting to transfer, but I have a bit of an issue with growing a thick lining, so it's always an anxious journey building up to the transfer as i've had to cancel before as It was just too thin, but I also had 4 that went ahead, so just trying to remember that! But yes, very looking forward to hopefully getting a positive one day - that would be nice! 😂🙈

No don't worry I'd rather be prepared and then not get it than think oh everything will be fine and not identify the warning signs/symptoms. Also not assume that a fresh transfer can go ahead. Aww well I'm glad that it ended okay but must have been horrible during it!!

No PCOS they said my AMH and AFC just happen to be decent (high side of normal) and likely due to being healthy and relatively young. Or maybe lucky. Earlier this afternoon I was still in quite a lot of discomfort but as the afternoon has gone on it's eased off quite a lot. But as the nurse said I'll keep topped up on the paracetamol as directed as of course the discomfort/pain could come back.

Haha well I was only semi asleep, I was still chatting to some of the staff but with my eyes closed and not fully with it I don't think. I don't remember a lot of it but I do remember a slight pinching feeling I think as the needle went on (but wasn't particularly painful). The anaesthetist did say not everyone needs to be put fully to sleep, that a lot will still talk throughout it but just not feel the pain or be as aware. He said if I wasn't tolerating it he could then fully put me asleep but doesn't look like I needed that!

Ahh that must be so annoying! What sort of thickness do you get to usually? Thankfully my lining has always seemed fine but I did find it odd that on Tuesday they measured my lining at 9mm and then the next day they measured it at about 7.5mm I think it was. Both days they were happy with it but the nurse said different people can measure slightly different places and it can just naturally fluctuate.

@strawberrylaces12 That's good that you have a good reserve. I have a high AMH and AFC too, despite being 35 which is why I got so many eggs this round and last. Fingers crossed you get a couple of nice embryo's out of those eggs too. That's good that you're feeling a bit better this afternoon! I just felt like I had period pains and like someone had been in there, but nothing 'pain' related per se.

No way! That's cool you were kinda away. And chatting haha. Do you remember what you were saying? I felt really drunk when the drugs were going in, and really spinny, then I woke up. It's mad that you can have all that go on and not really feel it isn't it?

I usually get to about 7mm ish, with a lot of shoving and pushing! Normally about 18 days of medication on the top dose. Anything over 6.5mm is what they want for a frozen, but it just takes a lot to get it where it wants to be. And I was the same with mine! It changed from the last scan to theatre, and then again after collection when I had OHSS so I think it varies and it does contract etc, so I think it can vary but 7.5 is good even if was lower than 9mm!

Wow imagine if you'd been doing this in your 20s! Your amh and afc is pretty high isn't it from what I recall? Yeah I'm 28 so they were expecting a decent amh and afc. My afc was maybe a bit higher than expected but they weren't concerned. And my ovaries didn't look polycystic on the scan, I have regular cycles etc. Amh of 34.9 and afc of 38 I think it was. I'm really hoping so, I'm nervous for the call tomorrow and then again next week to let us know the situation. But also keep reminding myself that there's nothing else I can be doing now. Yeah I've just taken my next dose of paracetamol (I'm spreading it out every 5 hours so I don't go over the 4 within 24 hours and so that I can have one not too long before I go to bed). But definitely feeling less sensitive there, for now anyway!

I think I was talking about where I'd been travelling and we were talking about my trip to Japan and I can't really remember what else now. I just hope I didn't say anything embarrassing but I'm sure they're used to it. I really wasn't aware of everything though as I'm fairly sure they said they strap your legs up and I can't remember that. Also I consented (before the procedure) to a pain killer rectally and I certainly don't remember that. The anaesthetist did say a lot of women think they were asleep throughout but often are chatting away 😂 did you just wake up and it was all over, like it had never happened?

Yeah fingers crossed both of us get good lining thickness before any transfers! 🤞😊

@strawberrylaces12 haha the perils of lean PCOS - I’m a prime target for ohss so like you say, imagine if I was 30 doing it! Yes high AMH (65) and AFC was 70 I think when they tested it 18 months ago. Yeah it’s not nice the waiting - having a good number to start with definitely increases your odds of a baby - it’s a numbers game after all unfortunately! I think when you know your fertilisation rate, the next wait isn’t as bad as the first. I said I’d be be happy with 1 embryo that was good quality, so if you have realistic expectations then I think it helps. Personally anyway!

oh strategic paracetamol taking - I like your style. Have you managed dinner tonight? Hopefully you’ll sleep well tonight and you feel relatively normal tomorrow 🤞haha that’s mad. I wonder the stuff people say.
yeah so o Jusy felt a bit tipsy and the room was spinny, then I woke up and said have you done it? 😂🤷‍♀️ and then called my nurse ginger 😂🙈

Oh wow yeah, high numbers for you! Very true about expectations. I'm going to try and think anything is a bonus really. I was so pleasantly surprised with the number of eggs today as I had lower expectations really.

Yeah the nurse recommended to keep up the paracetamol, even if I was starting to feel better pain wise just so it didn't suddenly come back again. But maybe tomorrow I'll just take it if/when needed. I guess it'll wear off over night so I can get an idea if I need it in the morning. I've mainly just snacked throughout the day and had lighter meals. Because it's been quite warm I've not wanted too much hot or heavy food, my wife has been the same too so we've just eaten when we felt like it. My wife bought me some treats, like a chocolate triffle/sundae which I enjoyed a lot as a reward for going through it 😂

I really expected to feel like I was spinning and/or sick but thankfully I didn't. Do you have many appointments coming up soon?

Unfortunately bad news. None of the eggs have fertilised. They are very shocked as both sperm and egg quality looked fine. They will call again tomorrow morning just in case any have managed to fertilise later on but said it's unlikely. Just trying to process it, very disappointed of course. Can't believe it really, out of 24 eggs... none??

Sorry to hear this @strawberrylaces12

Oh I'm so sorry @strawberrylaces12 ❤️

@strawberrylaces12 That’s so heartbreaking. Even more upsetting that the professionals can’t explain to you? There has to be a solution.

@strawberrylaces12 so sorry to hear!! Fingers crossed that hopefully SOME of them manage over the next 24hrs 🤞🏼

Thanks everyone. I'm just so confused and shocked. I've never seen anyone mention on here such a good number of eggs and none get fertilised? Especially at a young ish age and no know fertility issues/what looked like good egg and sperm quality.

Like I know there could be compatability issues so we could try with another donor if needed and then if it still doesn't work maybe it's an issue with me and my wife might try. But it's just so much to go through. I'd do it again if needed but just need time to process at the moment.

Oh @strawberrylaces12 im so so sorry to read this. I really had so much faith. I really hope they can find the reason and that some fertilise over the following day. Is this the same donor you used for IUI or is it a new one? Does it count as a round for your funding perspective if you didn’t make transfer? Really sorry. Thinking of you x

It's the same donor we used for our last few IUIs, we changed to them after 3 with another donor (as advised by our previous clinic who just do IUI and not IVF/ICSI). I had a phone call with the embryologist this afternoon so I could ask some questions (I was too in shock this morning). She said my eggs looked good quality, 19 mature out of the 24 and all were injected with none damaged by ICSI. About 11 of the eggs showed very early signs of responding but then just didn't fertilise. She does wonder if it was a sperm issue. The sample didn't thaw as easily as they would have liked and the count was lower which was why they converted to ICSI. But once it was thawed they found that there were plenty of sperm to choose from, so I'm just so confused.

She seemed positive that if we changed donor and maybe used an add on treatment (I can't remember the name of it, something to encourage calcium in the process of fertilisation) that we may have more success. But they were so shocked at the outcome and apparently it's really rare. Typical that I'm in the 5% or less that it happens to.

Got to take time to process it and think about next steps. I think we may try once more with another donor but if we have a similar issue then I may just need to assume it's an issue with me. My wife may try in the future if it doesn't work with me but isn't overly keen to really 😂

I'm pretty sure that's our funded finished now. We were funded for one egg collection and any transfers of embryos from that until a live birth. But a subsequent egg collection will have to be self funded now. So we just need to take some time to think what we want to do.

Completely heartbroken to be honest. I wasn't expecting loads (just to manage my expectations) but that phone call this morning came as I huge shock and I just couldn't believe it.

@strawberrylaces12 im glad you were able to speak again this afternoon to the embryologist and ask some questions. And that’s a really good mature from collection amount. So it does sound like a sperm issue which, when its donor, shouldn’t be the case. They have to be a certain quantity which is not really fair. It’s really honestly so upsetting and really got to me. I’m so upset for you I totally get you want some time to process and figure out what the next step is. There’s no rush though just take your time and do what you need to do.

if your wife isn’t sure, would you consider egg sharing and use her eggs and you carry or is it not appealing all the treatment side of things? Did they say that it’s likely some will fertilise late or did they not indicate?

Yeah I don't think we'll know for definite either way but the fact we've had to pay for donor sperm, if it is that I'd be so mad! I think once they thawed it the sperm looked fine but she said potentially the sperm didn't activate the egg properly (potentially it could be that there was an issue with the eggs activating but who knows). When we picked the donor it did say proven fertility on the profile but the embryologist said that fertilisation via natural/IUI can be different to IVF/ICSI. She's going to contact the clinic we were at for IUI and where we got the sample from to let them what has happened so it's flagged for them.

I think it's both that she is concerned about some genetics stuff from her side of things plus she doesn't really like the idea of being pregnant. So that's why we've gone with me doing the treatment. But we can potentially look at her going through treatment in the future if needed, would just need more consideration.

And they said they'd leave them in the incubator until tomorrow just in case, but it was very unlikely unfortunately :(

Hi @strawberrylaces12 this happened my friend and they said her eggs were just too thick. They went again for another round and used ICSI and she now has 10 frozen blastocyst...don't lose faith.

This was with ICSI unfortunately as our donor sperm (we're a same sex couple) was a lower count once thawed. Apparently the eggs were good quality and none were damaged during ICSI so just really bad luck. The embryologist did say with a different donor it may improve. But we need to think about next steps and if spending £8k+ on another go is sensible.

@strawberrylaces12 do you get refunded any of the IVF / ICSI costs, or at least what you paid for the donor sperm if it's a sperm issue?

No our NHS funding only covers one egg collection unfortunately. And we signed disclosures that if the donor sample didn't thaw as well that there would be no fault of the other clinic (we got this donor sperm from where we did IUI at a different clinic). We are lucky that we could afford another go but it's really not nice to have to pay out and not know if the same thing might happen.

Aw really sorry to hear that @strawberrylaces12 . Hopefully the clinic can suss out the issue ahead of the next round.

@strawberrylaces12 im so sorry to hear the eggs didn’t fertilize, especially when you had so many. It sounds like your eggs are fine so hopefully it’ll all go well if you try with different sperm. I’m heartbroken for you and thinking of you x